title: Association of trochlear dysplasia with degenerative abnormalities in the knee: data from the Osteoarthritis Initiative.
abstract: OBJECTIVE
  To evaluate trochlear morphology as a potential risk factor for patellofemoral osteoarthritis, determined by morphological and quantitative measurements of cartilage degeneration using 3-T magnetic resonance imaging (MRI) of the knee.
  
  
  METHODS
  MRI of the right knees of 304 randomly selected subjects, aged 45-60 years, from the Osteoarthritis Initiative (OAI) progression cohort were screened for trochlear dysplasia, defined by an abnormal trochlear depth. Out of 304 subjects, n = 85 demonstrated a shallow trochlea (depth ≤3 mm; 28 %). In these, and also in a random sample of controls with normal trochlear depth (n = 50), the facet ratio and the sulcus angle were calculated and knee structural abnormalities were assessed by using a modified Whole Organ MR Imaging Score (WORMS). Cartilage segmentation was performed and T2 relaxation times and patellar cartilage volume were determined. ANOVA and multivariate regression models were used for statistical analysis of the association of MRI structural measures and trochlear morphology.
  
  
  RESULTS
  Knees with a shallow trochlea showed higher patellofemoral degeneration (WORMS mean ± standard deviation, 11.2 ± 0.5 versus 5.7 ± 0.6; multivariate regression, P < 0.001) and lower patellar cartilage volume than controls (900 ± 664 mm(3) versus 1,671 ± 671 mm(3); P < 0.001). Knees with an abnormal medial-to-lateral facet ratio (<0.4) showed increased patellofemoral WORMS scores (12.3 ± 0.9 versus 8.3 ± 0.5; P < 0.001). Knees with an abnormal sulcus angle (>170°) also showed increased WORMS scores (12.2 ± 1.1 versus 8.6 ± 0.6; P = 0.003). T2 values at the patella were significantly lower in the dysplasia group with a shallow trochlea. However, significance was lost after adjustment for cartilage volume (P = 0.673).
  
  
  CONCLUSIONS
  Trochlear dysplasia, defined by a shallow trochlea, was associated with higher WORMS scores and lower cartilage volume, indicating more advanced osteoarthritis at the patellofemoral joint.
authors.affiliation: Musculoskeletal and Quantitative Imaging Group (MQIR), Department of Radiology and Biomedical imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA 94107, USA. pia.jungmann@tum.de
authors.forename: Pia M
authors.initials: PM
authors.lastname: Jungmann
authors.forename: Seng-Choe
authors.initials: SC
authors.lastname: Tham
authors.forename: Hans
authors.initials: H
authors.lastname: Liebl
authors.forename: Michael C
authors.initials: MC
authors.lastname: Nevitt
authors.forename: Charles E
authors.initials: CE
authors.lastname: McCulloch
authors.forename: John
authors.initials: J
authors.lastname: Lynch
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Link
mesh_terms: D000368:Aged; D015897:Comorbidity; D005260:Female; D005269:Femur / Q000002:abnormalities* / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000453:epidemiology* / Q000473:pathology*; D057071:Patellofemoral Joint / Q000002:abnormalities* / Q000473:pathology*; D015995:Prevalence; D015203:Reproducibility of Results; D012495:San Francisco / Q000453:epidemiology; D012680:Sensitivity and Specificity; D013223:Statistics as Topic